Epidemiology of Tick-Borne Diseases Among the Shepherd Community Along the Pak Baloch–Afghan Border

Background: Tick-borne diseases such as anaplasmosis and babesiosis represent emerging zoonotic threats in rural and borderland regions with limited surveillance, particularly among shepherd communities along the Pak Baloch–Afghan border. Despite increasing recognition globally, regional data on epidemiology, risk factors, and clinical burden remain scarce, hindering effective prevention and response strategies. Objective: This study aimed to investigate the epidemiological characteristics, occupational and environmental risk factors, and clinical outcomes of anaplasmosis and babesiosis among high-risk populations, with the goal of informing targeted interventions and integrated public health strategies. Methods: A cross-sectional observational study was conducted among high-risk individuals (n = 225) including shepherds, livestock handlers, butchers, and rural health workers. Participants aged 18–55 years were enrolled based on defined exposure criteria; individuals with prior confirmed infection were excluded. Data were collected via structured surveys, interviews, and laboratory diagnostics (PCR and ELISA) for Anaplasma phagocytophilum and Babesia microti. Statistical analyses including Chi-square and logistic regression were performed using SPSS v27 to identify significant associations (p < 0.05). The study received ethical approval from institutional review boards in both countries and adhered to the Helsinki Declaration. Results: Out of 225 suspected cases, 73 (33%) were confirmed for anaplasmosis and 72 (32%) for babesiosis. Males aged 20–50 years represented 86% of confirmed cases. Occupational exposure (OR = 4.2), male gender (OR = 3.5), and history of tick bites (OR = 2.8) were significantly associated with disease occurrence (p < 0.05). Spring and summer were peak transmission seasons. Immunocompromised individuals exhibited more severe symptoms, reinforcing the need for timely diagnosis and tailored care in remote settings. Conclusion: The study demonstrates a high prevalence of tick-borne diseases among occupational groups in the Baloch–Afghan borderlands, driven by vector exposure, environmental conditions, and limited protective practices. These findings underscore the importance of early detection, targeted awareness campaigns, and a One Health approach integrating human and animal health strategies to reduce disease burden in endemic rural areas.